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Adherence to antiretroviral therapy in patients enrolled in a comprehensive care program in Cambodia: a 24-month follow-up assessment.

Abstract : BACKGROUND: The long-term maintenance of antiretroviral therapy (ART) remains an important issue, especially in limited-resource settings where additional barriers exist. A cross-sectional study was performed 24 months after ART initiation for patients treated in Cambodia in order to estimate the prevalence and identify determinants of non-adherence. METHODS: Adults receiving ART for 24 +/- 2 months were considered eligible for the study. Self-reported non-adherence was defined according to an algorithm based on six items. The questionnaire also assessed ART-related side effects and HIV disclosure. HIV-1 RNA plasma viral load was measured using real-time PCR. Multivariate rare events logistic regression analysis was used to identify independent factors associated with non-adherence. RESULTS: A total of 346 patients participated in the study. At 24 months, 95% of patients were adherent, 80% had HIV RNA <40 copies/ml and 75% had CD4+ T-cell counts >200 cells/mm3. Virological success was significantly higher in adherent patients than in non-adherent patients (81% versus 56%, P=0.021). Living in a rural area, limited HIV disclosure and perceived lipodystrophy were independently associated with non-adherence. CONCLUSIONS: At 24 months, adherence to ART was high and explained positive virological outcomes. In order to maintain adherence and long-term virological benefits, special attention should be given to patients living in rural areas, those with lipodystrophy-related symptoms and others who express difficulties disclosing their condition to close family members.
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https://www.hal.inserm.fr/inserm-00320461
Contributor : Bruno Spire <>
Submitted on : Thursday, September 11, 2008 - 9:17:37 AM
Last modification on : Wednesday, August 19, 2020 - 11:16:30 AM
Long-term archiving on: : Friday, June 4, 2010 - 11:11:42 AM

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  • HAL Id : inserm-00320461, version 1
  • PUBMED : 18771053

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Bruno Spire, Patrizia Carrieri, Pal Sopha, Camelia Protopopescu, Narom Prak, et al.. Adherence to antiretroviral therapy in patients enrolled in a comprehensive care program in Cambodia: a 24-month follow-up assessment.. Antiviral Therapy, International Medical Press, 2008, 13 (5), pp.697-703. ⟨inserm-00320461⟩

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